Objective To compare the bacterial community profiles present in periodontium and root canals of the same tooth diagnosed as combined periodontal-endodontic lesions by using denaturing gradient gel electrophoresis (DGGE).Methods Samples were collected from 13 extracted teeth with advanced periodontitis,endodontic samples from root tip 1/3 root canal,and periodontal samples from the corresponding neighboring periodontium.Genomic DNA was collected for the following universal bacterial primersPCR.The PCR products were then loaded on the DGGE gels to gain separate bands.The typical DGGE bands were excised,PCR-cloned and sequenced.Results The number of bands,which was indicative of the number of bacterial species,was compared intra-group (periodontal and pulpal specimen from the same tooth).The difference was statistically significant (P＜0.01),but there was no positive correlation between them.The similarity (Dice Coefficient) between them was 13.1％-62.5％.Taxa identified through BLAST (≥98％ identity) were Campylobacter,Fusobacterium,Neisseria,et al in the periodontium,and Mogibacterium,Corynebacterium,Actinomyces,et al in the root canals.Conclusion Common bacteria existed between them,but not all of the periodontal bacteria would appear in neighboring root canal; and the bacteria in the root canal are not completely from neighboring periodontal tissue.The original bacteria in the root canals may resuscitate and enrich the bacterial community.In combined periodontal-endodontic lesions (periodontal source),it is probable that new species existed to be confirmed either in the periodontium or in the root canal.

Objective To analyze the levels of high density lipoprotein ( HDL) and low density lipoprotein ( LDL) among the staff in a college .Methods Fasting serum samples were collected from 2 234 paticipants .The lev-els of HDL and LDL in different sex and ages were estimated .Results The average value and abnormal rate of LDL in males were 3.20mmol/L and 49.1%,respectively.The average value of LDL in males was higher than normal val-ue.The average value and abnormal rate of LDL in females were 3.03mmol/L and 42.3%,respectively.The value of LDL in females who less than 54 years old was lower than that in males of the same age ( t=5.33,10.56,all P<0.01).Conclusion The abnormal rate of LDL had significant increase and the level in males was higher than that in females.The health education is necessary to prevent and control the abnormal level of LDL .

Objective To investigate principles of acupoint selection for the ancient acupuncture and moxibustion treatment of facial paralysis.Methods The ancient literature about acupuncture and moxibustion was collected and reviewed from the pre-Qin period to the late Qing Dynasty. According to the data selection criteria, acupuncture and moxibustion prescriptions of facial paralysis were collected and input into an ancient acupuncture and moxibustion prescription database. By use of frequency analysis and factor analysis, the principles of acupoint selection were obtained.ResultsTotally 257 prescriptions were collected which involve 74 acupoints. Through frequency analysis, 19 acupoints were obtained whose frequencies were equal or greater than 9, such as Dicang (ST 4), Jiache (ST 6), Tinghui (GB 2), Shuigou (GV 26), Hegu (LI 4), etc. Through factor analysis of acupoint variables, 6 common factors were obtained.Conclusion Based on analysis of the common factors, the principles of acupoint selection are summarized which were according to meridian, part and etiology for the ancient acupuncture treatment of facial paralysis. The results could provide a reference for clinical acupuncture and moxibustion treatment. It is feasible that factor analysis was applied to study principles of acupoint selection for acupuncture and moxibustion prescriptions.

Objective To evaluate a new self-designed device to assist closed reduction of femoral shaft fracture.Methods From January 2012 to June 2014,18 cases of femoral shaft fracture received closed reduction and internal fixation with anterograde intramedullary nails on a popular fluoroscopic orthopedic table.The new self-designed distraction reduction device was used during the operation.The patients contained 14 males and 4 females,aged from 21 to 48 years (mean,33.6 years).Fracture AO classification was type 32A2 in 8 cases,32A3 in 5 cases,32B1 in 3 cases and 32B2 in 2 cases.Mean pre-operation time was 5.5 days (range,3-10 days).Results Operation time ranged from 85 to 130 minutes (mean,96 minutes).Intraoperative bleeding ranged from 120 to 180 ml (mean,150 ml).X-ray fluoroscopy time ranged from 20 to 40 seconds (mean,25 seconds).Frequency of nailing into the distal fracture end was 1 to 3 times (mean,1.5 times).One case had additional small incision for open reduction.Fourteen cases experienced external rotational deformity of the femur from 2° to 6° (mean,3.6°) after surgery,and four cases were free of rotational deformity.All patients were followed up for 6 to 20 months (mean,12.8 months).All patients had fracture healing in a period of 4.5 to 8.5 months (mean,5.5 months).No iatrogenic fracture,infections,nail breakage or other complications occurred.At the final follow-up,knee score according to the system of hospital for special surgery (HSS) was found to be excellent in 12 cases,good in 4,and fair in 2,giving an excellent-togood rate of 89％.Conclusion The new self-designed distraction device is an easy-to-operate instrument that is useful in assisting distraction and reduction of the femoral shaft fracture diffictlt to be fixed with routine methods as well as intramedullary nailing just on a popular fluoroscopic orthopedic table.

Objective Increasing evidence supports the involvement of autophagy in the etiopathology of autoimmune diseases.Systemic lupus erythematosus (SLE) is a potentially fatal autoimmune disease characterized by production of multiple autoantibodies through poorly understood mechanism.In order to explore the role of autophagy in the development of SLE,the expression of autophagy related gene microtubule-associated protein 1 light chain 3 (MAPLC3) in peripheral blood mononuclear cells (PBMCs) was measured in patients with SLE.Methods The mRNA levels of LC3 in PBMCs from 56 SLE patients and 45 healthy individuals were detected by real-time quantitative polymerase chain reaction (qPCR) technique.Autophagy in PBMCs was also determined by flow cytometry (FACs) in 20 SLE patients and 15 healthy controls.The correlation between LC3 mRNA expression and disease activity of SLE (SLEDAI) was then analyzed.Results The mRNA level of LC3 (RQ) in SLE patients was obviously downregulated compared with that in healthy population (1.30 ± 0.10 vs 1.35 ± 0.09; P =0.029),paralleled with the decreased autophagy rate detected by flow cytometry in PBMCs of SLE patients [(2.21 ± 1.07) ％ vs (9.91 ±4.01) ％ ;P =0.047].Moreover,LC3 mRNA expression level was negatively correlated with SLEDAI (r =-0.337,P =0.023).However,when the clinical features of 27 SLE patients with decreased LC3 mRNA expression (RQ ＜ 1.351) were compared with those of other 29 SLE patients with normal or high LC3 mRNA expression (RQ ＞ 1.351),increasing rates of arthritis,serositis,hematological abnormalities were noted in patients with decreased LC3 mRNA expression yet without statistically significance.However,there was a significant difference between two groups in the incidence of renal involvement (P =0.028).Conclusion The impaired autophagy due to dowrnregulated LC3 mRNA level in SLE patients indicates that autophagy plays a role in mediating the occurrence and development of SLE.

Objective To evaluate the results of surgical treatment for patients with heterotaxy syndrome and cardiac anomaly.Methods From September 2008 to October 2013,34 patients with heterotaxy syndrome underwent 46 cardiac operations at Guangzhou Women and Children Medical Center.22 were male,and 12 female.Mean age at operation was 22 months (4 months to 14 year).There were right atrial isomerism 24 cases,left atrial isomerism 10 cases.Only one had a single VSD,and others were all with complex cardiac anomaly,including complete atrioventricular canal defect 26 cases,tricuspid atresia 4 cases,mitral atresia 1 case,anomalous pulmonary venous connection 18 cases,pulmonary venous stenosis 4 cases,double superior vena cava 17 cases,and interrupted hepatic portion of the inferior vena cava 5 cases.Fontan procedure was performed in 5 patients,bidirectional Glenn in 13,Kawashima in 3,central shunt in 1,atrioventricular valve replacement in 5,and pulmonary artery banding in 5.Results There were 4 died during hospitalization.The follow-up duration was 1 month to 5 years.There were 2 died.The early to middle term mortality was 17.6％ (6/34).In the same period the mortality for 103 patients without heterotaxy syndrome underwent univentricular repair was 4.8％ (5/103).There was significant statistical difference (P ＜ 0.05).Conclusion Right heart bypass operation remains the preferred palliative procedure for patients with heterotaxy syndrome,and the eraly and middle term results were satisfied.

Objective To review the outcomes of atrioventricular valve replacement in patients with functional single ventricle and evaluate risk factors for mortality.Methods Retrospectively reviewed our experience with atrioventricular valve (AVV replacement) in patients with functional single ventricle from January 2008 to December 2014.Outcome included mortality and valve-related complications.Results Thirteen patients required AVV replacement.Prosthetic valve type was St.Jude bileaflet mechanical mitral valve.Valve size ranged from 27 to 31 mm,including 27 mm in 2,29 mm in 7,and 31 mm in 4 patients.Median age at valve replacement was 4.5 years(range:1.2 years to 18.0 years).Concomitant procedures included bidirectional Glenn shunt in 3,pulmonary artery banding in 1,and repair of pulmonary vein stenosis in 1 patient.There were four early deaths with a perioperative mortality of 30.8％.Complications after AAV replacement included complete atrioventricuiar block in 1,intracerebral hemorrhage in 1 patient due to valve-related anticoagulation.No patient had perivalvular leakage.There was one late death during a mean follow-up of 3 years (range:0.5-5.0 years).Five-year Kaplan-Meier survival was 61.5％.Fisher exact probability test showed that lower weight(＜ 10 kg) at operation and prosthetic size/weight ratio ＞ 2.0 were risk factors for overall mortality.Of the survival patients,functional status is NYHA class Ⅰ in 3,class Ⅱ in 5.No patient developed valve-related complications.Conclusion Atrioventricular valve replacement can be performed in patients with functional single ventricle with acceptable mortality.Lower weight and increased prosthetic size/weight ratio at operation were significantly associated with worse survival.

Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P＜0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.

OBJECTIVETo discuss the experience of surgical treatment of total anomalous pulmonary venous connection (TAPVC) in infants.

METHODSThe clinic data of 84 cases with TAPVC under 6 months of age underwent surgical treatment at Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center from January 2012 to October 2015 were analyzed retrospectively. There were 58 male and 26 female patients. The patients were aged 1 days to 6 months with a mean of (2.4±2.2) months at surgery, including 22 newborns. Body weight was 1.8 to 6.8 kg with a mean of (4.3±1.2) kg. There were 24 cases of intracardiac type, 46 cases of supracardiac type, 10 cases of infracardiac type and 4 cases of mixed type. There were 26 cases received emergent operation. There were 14 cases used Sutureless technique in operations and 46 cases used conventional methods in the no-intracardiac type cases, and 2 cases enlarged the anastomsis with autologous pericardium. According to the condition, corrective surgeries of other anomalies were performed in the meantime, including 3 Warden operations (right side), 3 bilateral bidirectional Gleen operation, 2 correction of unroofed coronary sinus syndrome, 1 coarctation of aorta correction with deep hypothermic circulation arrest, and 1 repair of ventricular septal defect.

RESULTSThe ratio of newborn was higher in Sutureless technique group than in conventional methods group (7/14 vs. 32.6%, χ(2)=4.927, P=0.043), and mean age was less ((1.8±0.4) months vs. (2.4±2.2) months, F=4.257, P=0.042), but there were no difference in body weight, cardiopulmonary bypass time and aorta clamped time between the two groups. Followed up for 1 to 46 months, 10 cases (11.9%) died overall and the mortality of intracardiac (3/10) and mixed (2/4) type were much higher than in intracardiac (4.2%) and supracardiac (13.0%) type. The mortality were no difference between newborn and infants, or whether emergent operation, or Sutureless technique and conventional methods. The maximal pulmonary venous flow velocity was abnormal speed-up >1.8 m/s at 1 week and 1 to 3 months post-operation mostly.

CONCLUSIONSThe mortality of TAPVC was differed by different types. Intrinsic pulmonary vein stenosis maybe the main cause of mortality. The high quality of anastomsis could reduce the operative mortality.

Aortic Coarctation ; Body Weight ; Cardiac Surgical Procedures ; methods ; Circulatory Arrest, Deep Hypothermia Induced ; Female ; Heart Defects, Congenital ; mortality ; surgery ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Period ; Pulmonary Veins ; pathology ; surgery ; Retrospective Studies

Objective To evaluate the efficacy and safety of 0.03% tacrolimus ointment for the treatment of atopic dermatitis (AD) in Chinese children. Methods A total of 139 children, 2 to17 years of age, with moderate to severe AD from 5 study centres were enrolled in this multicentre, randomized, double-blind, vehicle-controlled, parallel group study. Treatment with 0.03% tacrolimus ointment or vehicle was applied twice daily to the affected areas for 3 weeks. Visits were scheduled on day 1 (base line, before treatment) and 1, 2, 3 weeks after the treatment. The main therapeutic parameter was the efficacy rate at the end of the treatment. Results The efficacy rates were 84.6% and 29.0% for tacrolimus group and vehicle group, respectively (P